慢性重度乙型肝炎住院患者应用临床路径的效果评价

Effect evaluation of clinical pathway application in inpatients with chronic severe hepatitis B

目的评价在慢性重度乙型肝炎(CSHB)住院患者中应用临床路径(CP)的效果。方法选择2014年10月至2016年5月重庆市某三甲医院感染病科收治的CSHB住院患者182例,将其分为CP组和非CP(NCP)组。CP组严格按照临床路径信息化系统所设定的流程进行标准化治疗;NCP组依照传统方法执行。评估两组患者住院时间、住院总费用、药品费用、检查检验费用、综合医疗服务费用和医疗材料费,并对患者进行满意度、疾病知识掌握度、出院后按时服药率及门诊随访率调查。结果CP组患者的住院时间、住院总费用、药品费用和检查检验费用明显低于NCP组(P<0.05);患者满意度(100.0%)及疾病知识掌握度(97.3%)均高于NCP组(分别为96.2%和92.4%)。CP组患者按时服药率与门诊随访率均为98.7%,高于NCP组的95.3%和92.5%,差异有统计学意义(P<0.05)。结论在CSHB患者中实施CP,能够明显缩短住院时间,减少住院费用,并提高患者满意度和依从性。

Objective To evaluate the effect of clinical pathway（CP） application in inpatients with chronic severe hepatitis B （CSHB）. Methods treated from October 2014 to May 2016A total of 182 inpatients with CSHB in the infectious department of a grade A class 3 hospital of Chongqing City were selected and divided into the CP group and non-CP group（NCP）. The CP group ac cepted the standardized treatment strictly according to the procedure set by the CP information system,while the NCP group was implemented the traditional treatment methods. The hospital stay, total hospitalization cost, drug expenses, examination cost, labora- tory testing cost, comprehensive medical services and medical material cost were evaluated in the two groups. The master rate of disease knowledge, satisfaction,rate of timely taking medication and outpatient follow-up rate after discharge were investigated and evaluated. Results Compared with the NCP group, the hospital stay length, hospitalization total cost,medication cost, examination cost and laboratory testing cost in the CP group were significantly lower than those in the NCP group（P〈0.05） ;the patient satis faction （100.0%） and master rate of disease knowledge （97.3%） were higher than 96.2% and 92.4% in the NCP group. The rate of regularly taking medication and outpatient follow-up rate after discharge all were 98.7 % in the CP group, which were higher than 95.3% and 92.5% in the NCP group,and the differences were statistically significant （P〈0.05）. Conclusion Implementing CP in the patients with CSHB can obviously shorten the hospitalization days,decreases the hospitalization cost, and improves the patient satisfaction and compliance.